Glaucoma is a group of eye diseases that cause progressive, irreversible damage to the optic nerve (vision nerve) that connects the eye to the brain.

How does this happen?

With glaucoma the fluid within the eye (aqueous humour) cannot drain out due to problems with the drainage system. This results in high intraocular pressure causing nerve tissue loss in the optic nerve. This is seen as `optic disc cupping’.

As a result of damage to the optic nerve, a patient with glaucoma has peripheral vision loss that can progress to involve their central vision. This damage is irreversible and can lead to blindness if not controlled. Because of this, it is important to control the glaucoma to preserve vision.

Normal optic disc left and optic disc cupping on the right

How will I know if I have glaucoma?

Initially one does not notice that anything is wrong. There is usually no pain or other symptoms. Only in advanced stages of disease will one notice problems with their vision.

Some risk factors for glaucoma include; being over the age of 40, African race, Asian race, diabetes, family history, high eye pressures, trauma and poor blood circulation in hands and feet.

Acute Glaucoma: Some people can get an acute glaucoma. Decreased vision, pain, redness and even headaches and nausea will be present. This is an ocular emergency.

Childhood glaucoma: Children can also get glaucoma. Younger children will have large corneas (buphthalmos – ox eyes), tearing and light sensitivity. They need early referral to an ophthalmologist. Older children with glaucoma will usually have high eye pressures.

How can I protect my vision?

Regular testing is the only way to pick up glaucoma before it damages a person’s vision
The South African Glaucoma Society recommends:

• If you are over 40, you should have your eyes tested every two years, and if you are over 60, you should have your eyes tested every year.
• If someone in your family has glaucoma, you should have your eyes tested regularly. This is especially important if the affected relative was under 40 years of age when the glaucoma was first discovered.

Treatment

Traditional treatment has been to use lifelong drops to lower eye pressures. If this didn’t stop progression, the next step would be surgical interventions.

The new line of thinking worldwide has emphasized the benefits of early surgical intervention. There are many new techniques and devices available to treat glaucoma.

Links:

• South African Glaucoma Society – https://www.sags.co.za
• American Association of Ophthalmologists https://www.aao.org/eye-health/diseases/what-is-glaucoma